amfAR, The Foundation for AIDS Research

Asia Faces Shortage of Trained AIDS Doctors

Treatment education failing to keep pace with proliferation of generic AIDS drugs, says Treat Asia Special Report


October 2004—As manufacturers of generic HIV/AIDS drugs begin to proliferate in Asia and growing numbers have access to lifesaving treatment, a serious shortage of trained physicians threatens to undermine the safe and effective delivery of antiretroviral therapy to the estimated 1.3 million people who need it (out of Asia’s 7.4 million HIV-positive individuals).

These were the principal findings of a special TREAT Asia report released on the eve of the XV International AIDS Conference in Bangkok in July. The report received widespread attention and its key findings gained prominent news coverage, including front-page articles in the International Herald Tribune and The Asian Wall Street Journal, and pieces in The India Tribune, The New York Times, The Wall Street Journal, and The Washington Post, as well as interviews with the Australian Broadcasting Corporation, BBC World Service, and Thai National Radio.

Reacting to the report in an interview with the International Herald Tribune, Dr. Joep Lange, outgoing president of the International AIDS Society, said, “We need to scale up training efforts quickly and develop a better mechanism
for quality control of drugs.”

The scarcity of trained doctors appears to be most dire in Viet Nam, where the report estimates that there is only one trained physician for every 11,250 HIV-positive people. Similarly low ratios across the region raise concerns that drug-resistant strains of HIV could flourish if medication is not administered or monitored properly.

“In the absence of trained healthcare workers,” says the report, “a significant number of people are likely to begin ‘self-medicating,’ independently purchasing antiretroviral drugs in local pharmacies and haphazardly taking drugs
with little or no direction.”

The report also documents the rapid expansion of the generic drug manufacturing industry in Asia. While only one company in all of Africa manufactures generic antiretroviral drugs, there are at least 27 producers of generic ARVs or ARV components in eight countries in Asia.

The report urges the creation of a regional database of generic manufacturers. “Without such a database,” it states, “it is impossible to determine which medications are available in a given country, evaluate the quality of those medications, or accurately gauge unmet medication needs among the HIV population.”

The full text of the TREAT Asia special report, entitled Expanded Availability of HIV/AIDS Drugs in Asia Creates Urgent Need for Trained Doctors, is available online at The report will be updated and expanded in 2005.